| NPI | 1417281270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001004529) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2025-11-18 |